Motor Speech and Dysphagia Flashcards

1
Q

A clinician in a hospital setting is asked to evaluate a 64 year old patient who appears to have dysarthria as a result of a TBI from falling and hitting the back of the lower position of his head. A detailed motor speech evaluation shows that the patient presents with slurred speech, imprecise consonants, distorted vowels, slow rate of speech, and excess and even stress. The patient’s motor movements are described by the nursing staff as “clumsy” and “uncoordinated.” Based on the given information, the clinician would most likely classify the patient’s dysarthria as
a. hyperkinetic dysarthria
b. hypokinetic dysarthria
c. ataxic dysarthria
d. flaccid dysarthria

A

c. ataxic dysarthria

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2
Q

Which of the following dysarthrias are associated with Parkinson’s disease?
a. spastic
b. flaccid
c. hypokinetic
d. hyperkinetic

A

c. hypokinetic

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3
Q

Amyotrophic lateral sclerosis results in which kind of mixed dysarthria?
a. spastic-ataxic
b. flaccid-spastic
c. hypokinetic-spastic
d. flaccid-ataxic

A

b. flaccid-spastic

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4
Q

Which of the following is characteristic of AOS but not dysarthria?
a. consistent errors regardless of length and complexity of utterance
b. difficulty performing both non-speech and speech motor tasks
c. predictable errors
d. normal strength, tone, and range of movement of oral and pharyngeal muscles

A

d. normal strength, tone, and range of movement of oral and pharyngeal muscles

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5
Q

Purposeless, random, involuntary movements of body parts associated with hyperkinetic dysarthria is known as
a. myoclonus
b. chorea
c. tics
d. tremors

A

b. chorea

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6
Q

Which of the following is not a disorder of the pharyngeal phase of swallowing?
a. Decreased laryngeal elevation
b. Reduced tongue base retraction
c. Decreased UES opening
d. Premature spillage over base of tongue

A

d. Premature spillage over base of tongue

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7
Q

For which of the following disorders of swallowing would it be inappropriate to recommend tilting the head to the strong side?
a. unilateral weak pharyngeal constriction
b. decreased laryngeal elevation
c. decreased UES opening
d. incomplete epiglottic inversion

A

a. unilateral weak pharyngeal constriction

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8
Q

AOS is often associated with
a. lesions in Broca’s area
b. lesions in Wernike’s area
c. lesions in subcortical structures
d. lesions in occipital area

A

a. lesions in Broca’s area

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9
Q

Dysarthria is
a. a speech disorder in the absence of muscle weakness or paralysis
b. a speech disorder never associated with aphasia
c. a single disorder with a unitary etiology
d. a speech disorder associated with muscle weakness or paralysis

A

d. a speech disorder associated with muscle weakness or paralysis

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10
Q

Of the following symptoms, the one associated with dysarthria is
a. even and consistent breakdowns in articulation
b. impaired syntactic structures
c. forced inspirations and expirations that interrupt speech
d. an invariably slower rate of speech

A

c. forced inspirations and expirations that interrupt speech

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11
Q

A clinician in a SNF receives a note that Dick, a new 80 year old patient, has been transferred to her facility. The note states that Dick was assessed by the clinician in the previous SNF, but there is no diagnosis in the papers that have been sent from the previous clinician. However, she reported that Dick manifested the following symptoms: general awareness of his speech problems, significant articulation problems, problems with volitional speech with relatively intact automatic speech, more difficulty with consonants than vowels, intonation and fluency problems, and trial and error groping and struggling with associated speech attempts. Therapy was recommend. Dick most likely has
a. hyperkinetic dysarthria
b. unilateral upper motor neuron dysarthria
c. right hemisphere syndrome
d. AOS

A

d. AOS

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12
Q

Lucien, a 22 year old male, is hospitalized after sustaining a TBI from a MVA. There is no injury to the cerebellum, brainstem, or peripheral nerves. When assessing Lucien, the clinician may expect to find
a. dysarthria, confused language (confabulations), auditory comprehension problems, confrontation naming problems, perseveration of verbal responses, pragmatic language problems, and reading/writing difficulties
b. dysarthria, confused language (confabulations), auditory comprehension problems, no confrontation naming problems, and agrammatic or telegraphic speech
c. confrontation naming problems, perseveration of verbal responses, pragmatic language problems, intact reading/writing abilities, and echolalia
d. severely impaired fluency, severe echolalia, agrammatic and telegraphic speech, and intact auditory comprehension skills

A

a. dysarthria, confused language (confabulations), auditory comprehension problems, confrontation naming problems, perseveration of verbal responses, pragmatic language problems, and reading/writing difficulties

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13
Q

Which of the following is considered an exercise for patients with dysphagia and should not be preformed with food?
a. masako maneuver
b. supraglottic swallow
c. mendelsohn maneuver
d. effortful swallow

A

a. masako maneuver

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14
Q

Which of the following would be inappropriate to recommend for a patient with dysphagia due to poor base of tongue retraction?
a. use of chin tuck
b. swallowing multiple times for one bolus
c. lingual sweep of lateral sulci
d. effortful swallow

A

c. lingual sweep of lateral sulci

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15
Q

A clinician is asked to give a workshop to graduate students about evaluation of patients with swallowing disorders. She discusses evaluation in depth, Which of the following facts in the clinician’s workshop would be inaccurate?
a. an ultrasound examination can measure oral tongue movement and hyoid movement
b. a manometric assessment can assess the preparatory phase of the swallow using posterior and lateral plane examination
c. an electromyographic assessment can be conducted by attaching electrodes on structures of interest (i.e., oral, laryngeal, pharyngeal muscles)
d. a laryngeal examination can be conducted with indirect laryngoscopy or endoscopic examination to inspect the base of tongue, vallecula, epiglottis, pyriform sinuses, vocal folds, and ventricular folds

A

b. a manometric assessment can assess the preparatory phase of the swallow using posterior and lateral plane examination

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